Ciência da palhaçaria: estudos teóricos e práticas em saúde mental / Science of clowning: theoretical and practical studies in mental health/

O livro Ciência da Palhaçaria: estudos teóricos e práticas em saúde mental aborda no campo da saúde possibilidades de pensar cientificamente a arteterapia, principalmente da palhaçaria. O nariz vermelho do palhaço simboliza o potencial aplicado da arte na saúde mental. Deste modo, apresentamos vários trabalho sob a luz da ciência, para que mais pessoas pudessem conhecer essa experiência e receber este cuidado em saúde como fundamentação para novas práticas.

Sistema de actividades sobre dibujo anatómico para el desarrollo de habilidades en estudiantes de Estomatología / System of activities on anatomical drawing for the development of skills in dentistry students

Fundamento: el dibujo anatómico desde la propia clase aporta a los estudiantes de Estomatología mayor destreza manual, ligereza psicomotora y mejor percepción estética, lo cual responde a su formación profesional. Objetivo: diseñar un sistema de actividades de dibujo anatómico para el desarrollo de habilidades manuales e intelectuales en los estudiantes de Estomatología. Métodos: se realizó un estudio descriptivo de corte transversal en la Facultad de Estomatología entre enero de 2018 a diciembre de 2020. El diseño metodológico se desarrolló en tres etapas: diagnóstica, de diseño y valoración, y de implementación y evaluación. Se emplearon los métodos teóricos: histórico-lógico, analítico-sintético e inductivo-deductivo; empíricos: análisis documental, cuestionario y entrevista; y estadísticos-matemáticos: la estadística descriptiva para la elaboración de tablas y gráficos, así como el análisis porcentual para el procesamiento de los datos obtenidos en el diagnóstico y en la valoración ofrecida por los especialistas. Resultados: se realizó un estudio diagnóstico, el cual determinó que existían dificultades en el desarrollo de habilidades manuales e intelectuales en los estudiantes de Estomatología, sobre cuya base se diseñó un sistema de actividades que se implementó mediante un curso electivo y en algunos temas de la disciplina. Conclusiones: se diseñó un sistema de actividades de dibujo anatómico que contribuyó al desarrollo de habilidades manuales e intelectuales en los estudiantes de Estomatología para dar solución a problemas vinculados a la actividad profesional y la vida diaria. Fue valorado por especialistas como una respuesta acertada al problema investigado, a partir de la novedad y el nivel científico.

Background: anatomical drawing from the class itself provides Dentistry students with greater manual dexterity, psychomotor lightness and better aesthetic perception, which responds to their professional training. Objective: to design a system of anatomical drawing activities for the development of manual and intellectual skills in Dentistry students. Methods: a descriptive cross-sectional study was carried out at the Faculty of Dentistry from January 2018 to December 2020. The methodological design was developed in three stages: diagnostic, design and assessment, and implementation and evaluation. Theoretical methods were used: historical-logical, analytical-synthetic and inductive-deductive; empirical ones: documentary analysis, questionnaire and interview; and statistical-mathematical ones: descriptive statistics for the preparation of tables and graphs, as well as percentage analysis for processing the data obtained in the diagnosis and in the assessment offered by specialists. Results: a diagnostic study was carried out, which determined that there were difficulties in the development of manual and intellectual skills in Dentistry students, on the basis of which a system of activities was designed, that was implemented through an elective course and in some topics of the discipline. Conclusions: a system of anatomical drawing activities was designed that contributed to the development of manual and intellectual skills in dentistry students to solve problems related to professional activity and daily life. It was valued by specialists as a correct response to the investigated problem, based on its novelty and scientific level.

Anotações de um Jovem Médico e Outras Narrativas, de Mikhail Bulgákov / A Country Doctor's Notebook / Diario de un joven médico

Apesar de ter sido escrito há quase cem anos, Anotações de um jovem médico, de Mikhail Bulgákov, continua uma reflexão excepcionalmente bem escrita sobre a prática médica em forma de narrativa. Ao misturar as suas próprias experiências como único médico em uma área rural com a sua maestria literária, Bulgákov é capaz de capturar o que há de universal nas experiências de ser um médico inexperiente. Para médicos em países em desenvolvimento ou áreas remotas, ainda mais paralelos podem ser traçados. Temas como síndrome do impostor, vieses, falhas, responsabilidade pessoal e outros são abordados.

Despite being written nearly a hundred years ago, A Country Doctor's Notebook, by Mikhail Bulgakov, remains an exceptionally well-crafted reflection on medical practice in narrative form. By blending Bulgakov's own experience as the only doctor in a rural area and his literary mastery, he is able to bring out the universal experience of being an inexperienced doctor. For practitioners in developing countries or remote areas, such as the author, even more parallels can be drawn. Themes such as impostor syndrome, bias, failures, personal responsibility, and others are addressed.

A pesar de haber sido escrito hace casi cien años, Diario de un joven médico, de Mikhail Bulgakov, sigue siendo un reflejo excepcionalmente bien elaborado de la práctica médica en forma narrativa. Combinando la propia experiencia de Bulgakov como médico en una zona rural y su maestría literaria, él es capaz de sacar a relucir la experiencia universal de ser un médico inexperto. Para los profesionales en países en desarrollo o áreas remotas, se pueden establecer aún más paralelismos. Se abordan temas como el síndrome del impostor, sesgos, fracasos, responsabilidad personal y más.

Teatro em cena no processo ensino-aprendizagem para abordagem da violência contra mulheres: relato de experiência / Teatro enes cenaen el proceso de enseñanza-aprendizaje para abordar la violencia contra las mujeres: relato de experiencia / Theater on the scene in the teaching-learning process to approach violence against women: experience report

RESUMO Objetivo relatar a construção, organização e apresentação de peça teatral com abordagem acerca da violência contra mulheres. Método trata-se de relato de experiência acerca da utilização do teatro no processo ensino-aprendizagem para abordagem da violência contra mulheres. A atividade foi desenvolvida nos meses de abril a novembro de 2019, sendo elaborada em três etapas: (1) Construção do roteiro; (2) Ensaios e organização e (3) Apresentação. Os dados foram analisados mediante análise categorial temática e apresentados de forma descritiva, emergindo quatro categorias temáticas e seis subcategorias, discutindo-os conforme a literatura pertinente. Resultados evidencia-se a importância de utilização dessa tecnologia educativa para favorecer o processo ensino-aprendizagem, desde a construção até a apresentação da peça, possibilitando, aos graduandos, estímulo à criatividade, fortalecimento das relações sociais, criticidade, respeito e a capacidade de pactuação ao oportunizar o desenvolvimento de competências imprescindíveis para o exercício profissional, convivência coletiva e trabalho transdisciplinar. Conclusão e implicações para a prática a vivência foi considerada exitosa, pois constitui estratégia educativa que possibilitou, aos graduandos, desenvolvimento de aptidões cruciais para o reconhecimento e a assistência às mulheres em situação de violência.

RESUMEN Objetivo relatar la construcción, organización y presentación de una obra de teatro con abordaje de la violencia contra la mujer. Método se trata de un relato de experiencia sobre el uso del teatro en el proceso de enseñanza-aprendizaje para abordar la violencia contra la mujer. La actividad se desarrolló de abril a noviembre de 2019, siendo elaborada en tres etapas: (1) Construcción del guion; (2) Ensayos y organización y (3) Presentación. Los datos fueron analizados a través del análisis categórico temático y presentados de forma descriptiva, surgiendo cuatro categorías temáticas y seis subcategorías, discutiéndolas de acuerdo con la literatura relevante. Resultados se evidencia la importancia del uso de esta tecnología educativa para favorecer el proceso de enseñanza-aprendizaje, desde la construcción hasta la presentación de la obra, capacitando a los estudiantes para estimular la creatividad, fortaleciendo las relaciones sociales, la criticidad, el respeto y la capacidad de acuerdo al brindar oportunidades para el desarrollo de competencias esenciales para el ejercicio profesional, la convivencia colectiva y el trabajo transdisciplinario. Conclusión e implicaciones para la práctica la experiencia se consideró exitosa, ya que constituye una estrategia educativa que permitió, a los estudiantes de grado, desarrollar habilidades cruciales para reconocer y ayudar a las mujeres en situación de violencia.

ABSTRACT Objective Report the construction, organization and presentation of a play with an approach to violence against womens. Method This is an experience report about the use of theater in the teaching-learning process to approach violence against womens. The activity was developed from April to November 2019, being elaborated in three stages: (1) Construction of the script; (2) Essays and organization and (3) Presentation. Data were analyzed through thematic categorical analysis, presented in a descriptive way, emerging four thematic categories and six subcategories, discussing them according to the relevant literature. Results It highlights the importance of using this educational technology to favor the teaching-learning process, from the construction to the presentation of the play, enabling undergraduates encouragement to creativity, strengthening of social relations, criticality, respect and the capacity for agreement, by providing opportunities for the development of essential skills for professional practice, collective coexistence and transdisciplinary work. Conclusionan and implications for practice The experience was considered successful, as it constituted an educational strategy that enabled undergraduates to develop crucial skills for recognizing and assisting to women in situations of violence.

La Digitalis. Una planta ligada al arte / Digitalis. A plant linked to art

Resumen La Digitalis purpúrea ha sido utilizada por sus propiedades terapéuticas desde la antigüedad hasta nuestros días. Su difundido uso, tanto como la diversidad de indicaciones que tuvo, permitió que también se conociese desde antaño los riesgos a la salud para quien recibiese una dosis excesiva. La toxicología actual conoce y maneja perfectamente la intoxicación digitálica, sin embargo, muchas historias relacionadas con su uso son poco conocidas. Se presentan algunas de estas historias, muchas de ellas relacionadas con el mundo del arte.

Abstract Digitalis purpurea has been used because of its therapeutic properties since ancient times up to our days. Its wide- spread use as well as the variety of indications that it covered allowed to know the risks for health in case of overdose. Present toxicology is aware and knows perfectly well how to treat digitalic poisoning. However, many stories about digitalis are little known. Here, we show you some of them, specially the ones related with arts.

Investigación en salud basada en las artes. Reflexiones desde la experiencia Madrid Salud / Arts-based health research. Reflections from the Madrid health experience

Este artículo reflexiona sobre los supuestos de la investigación en salud basada en las artes (Art-Based Health Research) a partir de la experiencia del Proyecto Arte y Salud en el organismo público Madrid Salud del Ayuntamiento de Madrid. Las investigaciones en el ámbito del arte y la salud tienen una amplia trayectoria que permite un análisis crítico de los aportes y también una reflexión sobre su trascendencia e impacto. El artículo recoge aspectos de la investigación en salud basada en las artes, que se sustenta en la investigación basada en las artes y que plantean cuestiones y conflictos teóricos, metodológicos y éticos. El trabajo desarrollado en Madrid Salud desde en 2011 permite una revisión desde la práctica de estas cuestiones y un amplio campo de experimentación para reflexionar sobre los retos de este enfoque de investigación

This article reflects on the assumptions of Art-Based Health Research based on the experience of the Art and Health project in the public agency health of the Madrid City Council. Research in the field of art and health has a long trajectory that allows a critical analysis of the contributions and also a reflection on the transcendence and impact of such research. The article gathers aspects of Arts-Based Health Research, which is based on arts-based research, and which raise theoretical, methodological and ethical questions and conflicts. The work developed in Madrid's health since 2011 allows a review from the practice of these issues and a wide field of experimentation to reflect on the challenges of this research approach.

Arte, historia y endocrinología / Art, history and endocrinology

Las enfermedades han sido representadas en el arte desde tiempos remotos. Las obras pictóricas muchas veces nos muestran trastornos que aún no se constituían como una entidad. Observar estos cuadros a la luz de la historia de las enfermedades nos da una perspectiva enriquecedora que nos ayuda a entender mejor dichas patologías. Se comenta un caso clínico endocrinológico pediátrico, la historia probable y su descripción física. Se revisa la historia de cómo se llegó a dilucidar la enfermedad y las claves de su tratamiento.

Diseases have been represented in art since ancient times. Paintings often show us disorders that had not yet been described as a pathological entity. Looking at these pictures in the light of the history of the diseases gives us an enriching perspective that helps us to better understand those pathologies. On this background a pediatric endocrinological clinical case, the most probable history and the features of the physical examination are discussed. The history of how the disease was uncovered and the keys of its treatment are reviewed.

El niño con enfermedades infecciosas en las artes visuales: pintura / The child with infectious diseases in the visual arts: painting

Resumen: El impacto catastrófico de las enfermedades infecciosas sobre la salud infantil, como también el rol trascendental y benéfico aportado por la instauración y ejecución de medidas sanitarias y de inmuno- prevención ha sido un tema recurrente en la historia de la medicina, aunque una vez logrado el con trol de la enfermedad, estas pasan fácilmente al olvido. Ante esto, parece necesario rememorar aquel escenario social mediante un acercamiento a través de la pintura. Las obras pictóricas son testigo de aquello, pues las enfermedades son objeto de representación y a su vez se han convertido en un in valuable documento en la historia de la medicina. Patologías pediátricas como tuberculosis, difteria, poliomielitis, sarampión, viruela y sífilis como también el inicio de la vacunación, son analizadas en diversas pinturas con el objetivo de profundizar el conocimiento de la época histórica, el autor y su vínculo con dicha enfermedad.

Abstract: The catastrophic impact of infectious diseases on children's health, as well the transcendental and be neficial role played by the establishment and execution of health measures and immunoprevention, has been a recurrent subject in the history of medicine, although once the disease has been controlled, they are easily forgotten. In view of this, it seems necessary to recall that social scenario through an approach through painting. The pictorial works are witnesses of that since diseases are subject of representation, and at the same time, they have become an invaluable document in the history of me dicine. Pediatric pathologies such as tuberculosis, diphtheria, polio, measles, smallpox, and syphilis, as well as the initiation of vaccination, are analyzed in various paintings with the aim of deepening knowledge of the historical era, the author and his or her link to this disease.

Miguel Ángel y el hígado de Noé: ¿Una lección secreta de anatomía? / Michelangelo and Noah's liver: a hidden anatomy lesson?

Miguel Ángel Buonarroti (1475 - 1564) es considerando uno de los más grandes artistas de la historia. Estudió en detalle la anatomía humana a través de la disección de cadáveres, práctica hasta entonces relegada por motivos religiosos. Desde que en el año 1990 el médico Frank Lynn Meshberger publicara su interpretación del fresco "La Creación de Adán" basada en la neuroanatomía, en donde comparaba la imagen de Dios con la de una sección sagital del cerebro humano, muchos autores han encontrado diversas referencias anatómicas ocultas en la obra de Miguel Ángel. En el presente trabajo exponemos el hallazgo de una inédita lección de anatomía hepática oculta en el fresco La Embriaguez de Noé de la Capilla Sixtina.

Michelangelo Buonarroti (1475 - 1564) is considered one of the greatest artists in history. He studied in detail the human anatomy through corpses dissection, practice until then relegated for religious reasons. Since the physician Frank Lynn Meshberger published in 1990 his interpretation of the fresco "The Creation of Adam" based on neuroanatomy, where he compared the image of God with a sagittal section of the human brain, many authors have found various hidden anatomical references in the work of Michelangelo. In the present paper we expose the finding of a hidden lesson on liver anatomy in the fresco The Drunkenness of Noah of the Sistine Chapel.

Mascotas felinas, medicina y arte / Pet cats, medicine and art

The author in this short text remembers the passing of a beloved pet cat. Cats are beautiful animals and wonderful companions. They evolved together with humans in Africa, subsequently spread over the five continents with them, and became the subject of many human cultural activities, including art, poetry and religion. Abandoned and roaming free, cats readily return to the wild, potentially acquiring many zoonotic infections. Surprisingly, feline company is increasingly used for therapy of mental and other illnesses such as cardiovascular disorders. Responsible ownership and good veterinary care of these marvelous animals under the One Health paradigm are essential to their well-being as well as to that of humans. They are an ethical and small price to pay for the affectively rewarding relationships humans have with these endearing and evocative animals.

William Hunter (1718-1783): su legado a trescientos años de su nacimiento / William Hunter (1718-1783): his legacy three hundred years from his birthday

The aim of this paper is to evaluate some aspects of the life of William Hunter (1718-1783), and to argue that he deserves a better place in history as he was one of the most outstanding figures in British medicine of the 18th century. A Scotsman, Presbyterian, from a family without means or connections, he underwent a classic education at the University of Glasgow, completed with apprenticeships with William Cullen and Alexander Monro first in Scotland, and then in London, with William Smellie, James Douglas and James Wilkie, in anatomy, obstetrics and surgery, respectively. Despite initial disadvantages, he was highly successful as an anatomist, educator, surgeon, man-midwife, artist, gentleman and collector. He moved and had influences in the highest medical, cultural and social circles of his time, was named Physician Extraordinary to Queen Charlotte, and was a member of many scientific, medical and cultural societies in Great Britain and in France, such as the Royal Society, the Royal College of Physicians and the Societé Royale de Médicine of Paris. His museum was notable in its magnitude and its diversity, including anatomical preparations, coins, shells, plants, birds, insects, fossils, and minerals. He donated his great museum to the University of Glasgow. His figure has been relegated mainly due to the absence of heirs, individuals or institutional, that could have cared for, maintained, and increased his legacy as happened with his brother John.

A arte de pintar o ventre materno: história oral de enfermeiras e obstetrizes / El arte de pintar el vientre materno: la historia oral de las enfermeras y parteras / The art of maternal womb painting: oral history of nurses and midwives

Resumo Objetivou-se, neste estudo, descrever quando, como e por que a enfermeira e a obstetriz aplicam a pintura no ventre de gestantes. Tratou-se de uma pesquisa exploratória, de abordagem qualitativa, na qual foi adotado o método da história oral temática. Participaram sete profissionais de saúde que aplicam a pintura no ventre e atendem gestantes no Brasil. A coleta ocorreu por meio de entrevistas, realizadas entre os meses de janeiro e maio de 2016. Os dados foram analisados com base na análise temática de conteúdo, de Laurence Bardin. A partir dos discursos, elaborou-se uma árvore histórica da pintura no ventre e emergiram três categorias que elucidam quando, como e por que a enfermeira e a obstetriz aplicam esta arte. Conclui-se que a pintura no ventre tem sido adotada no cuidado pré-natal e dentro da maternidade como estratégia de educação em saúde e na promoção do bem-estar materno e familiar.

Resumen El objetivo de este estudio fue describir cuándo, cómo y por qué la enfermera y la partera aplican la pintura en el vientre de mujeres embarazadas. Se trata de un estudio exploratorio cualitativo, donde se adoptó la metodología de la historia oral temática. Participaron siete profesionales de salud, los cuales aplican la pintura en vientre y atienden a mujeres embarazadas en Brasil. La recolección de datos ocurrió a través de entrevistas, realizadas entre Enero y Mayo de 2016. Los datos fueron analizados de conformidad con el análisis temático de contenido, de Laurence Bardin. A partir de los informes, ha sido elaborado un árbol histórico de la pintura en el vientre, junto a eso emergieron tres categorías las cuales aclaran cuándo, cómo y por qué la enfermera y partera aplican este arte. Se concluye que la pintura en el vientre ha sido adoptada en la atención prenatal y también dentro de la maternidad como estrategia de educación en salud, además de promover el bienestar materno y familiar.

Abstract The present study aimed to describe when, how and why the nurse and the midwife apply the painting on pregnant wombs. It was an exploratory research, qualitative approach, in which thematic oral history was adopted as method. Seven health professionals, who apply painting on the womb and attend pregnant women in Brazil, took part of it. The data provided through interviews conducted between January and May 2016. Data were examined based on the thematic analysis of content, of Laurence Bardin. From the interviews, historical tree of womb painting has been drawn up and three categories emerged, which clarify when, how and why the nurse and the midwife apply this art. The womb painting has been adopted in the prenatal care and in the maternity as a strategy for health education and the promotion of maternal and family well-being.

El conocimiento anatómico en el Perú preincaico / The anatomical knowledge in the pre-Inca era in Peru

En el antiguo Perú, en la era preincaica, en la localidad de Sechín, sus habitantes dejaron grabados en piedras una serie de imágenes anatómicas, que tal vez constituyan los testimonios más antiguos de disecciones humanas realizadas en el mundo. (AU)

In Ancient Peru, in the pre-Inca era, in the town of Sechin, its habitants left engravings in stones a series of anatomical images, which may be the oldest testimonies of human dissections made in the world. (AU)

El retablo de Isenheim: religión, arte y medicina / The Isenheim altarpiece: religion, art and medicine

Northern Europe at the beginning of the 16th Century was in turmoil as a result of religious and political dissention, epidemics of plague, syphilis, ergotism, and famine, and the threat of the Ottoman Empire. In Alsace, a fulcrum between Germany, France, Switzerland and the Netherlands, Grünewald painted his celebrated and complex altarpiece at Isenheim in a convent chapel of the Antonine religious order that kept a hospital for the care of patients suffering from ergotism, plague, syphilis and other illnesses. The ten paintings of this altarpiece convey a series of religious, medical and political meanings, with the scenes of the Crucifixion and the Resurrection being thought to play an integral part of the curative process. This was because patients could be soothed by comparing their suffering to that of Christ on the cross and could console themselves by the Resurrection. The portrait of Christ in the cross is astounding in its realism and naturalism. It represents, with great pathological veracity, a tortured body in agony, a break with previous traditional representations of this event. Impressive pathological detail is also given to a figure in the Temptation scene. The entire work is suffused with religious connotations provided by the composition, the forms and the richness and sophisticated use of colors. Although Grünewald's paintings are few and the facts of his personal life sparse, it is known he married a Jewish woman, supported the peasant revolts, and was probably a Lutheran in a Catholic area. While Grünewald is considered the epitome of a German artist, the universal projections of his art have influenced physicians and the artistic productions of many painters, writers, musicians and sculptors throughout the world.

Los proyectos artísticos en la formación humanística de los estudiantes de medicina / Artistic projects in the humanistic training of medicine students

Se realizó un análisis sobre la importancia del arte en el contexto de la salud con el objetivo de interpretar de una manera científica y lógica las potencialidades que brindan las manifestaciones artísticas como vía pedagógica de formación humanista de los jóvenes y futuros galenos, así como la implementación de proyectos en la comunidad universitaria y la sociedad en general, con énfasis en los centros hospitalarios pediátricos, lo que favorece la relación entre el médico y el paciente bajo régimen de ingreso y su familia

An analysis on the importance of arts in the health context was carried out aimed at interpreting in a scientific and logical way the potentialities that offer the artistic manifestations as a pedagogical and humanistic way of training the youth and future physicians, as well as on the implementation of projects in the university community and society in general, with emphasis in pediatric hospitals, what favors the relationship between doctors, patients and family during admission.

The art and neurology of Paul Richer / A arte e a neurologia de Paul Richer

ABSTRACT In the 1890s, one of Charcot's most important protégés, Dr. Paul Richer (1849-1933), drew and sculpted a series of representations of the main types of nerve pathology. That series included drawings of pleomorphic hysterical crises and sculptures depicting patients suffering from labio-glosso-laryngeal paralysis and myopathy, as well as Parkinson's disease. Richer was a resident at La Salpêtrière and, in 1882, became head of the Charcot museum. Early in his career, despite having no formal artistic training, he could represent masterfully, in drawings and sculptures, people's tragic suffering from neurological diseases. Later on, with the same tools, he expressed the beauty of human movements in health.

RESUMO Nos anos 1890, um dos mais importantes protegidos de Charcot, o doutor Paul Richer (1849-1933), desenhou e esculpiu uma série de representações figurativas dos principais tipos de patologia nervosa. Essa série incluiu desenhos de crises histéricas pleomórficas e esculturas de bustos representando pacientes que sofriam de doenças tais como: paralisia labio-glosso-laríngea, miopatia e doença de Parkinson. Richer foi residente de La Salpêtrière e, em 1882, foi nomeado chefe do museu de Charcot. Na primeira parte de sua carreira e sem qualquer treinamento artístico formal, ele conseguiu representar, como ninguém, em desenhos e esculturas, o trágico sofrimento das doenças neurológicas. Mais adiante, com as mesmas ferramentas, ele concebeu a beleza do movimento humano na saúde.